LACTATION AND FOOD SUPPORT DELIVERY THROUGH THE CANADA PRENATAL NUTRITION PROGRAM IN ONTARIO: A QUALITATIVE STUDY

The Canada Prenatal Nutrition Program (CPNP), funded federally since 1995, aims to improve birth outcomes and breastfeeding among families facing health inequities through tailored, community-based delivery of perinatal health and nutrition services. To explore Ontario CPNP coordinators' perspectives and experiences delivering lactation and food supports, including changes over time, this qualitative study engaged coordinators working at multiple Ontario CPNP sites. A total of 28 individuals participated from 26 CPNP sites, 15 hosted by community agencies, 6 by Indigenous-led agencies and 5 by public health units. Focus group discussions were conducted at five locations across Ontario, audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Three interpretive themes were generated. The first, overarching theme is that the CPNP delivery model is highly precarious due to limited, static funding, resulting in heavy reliance on external and in-kind resources; this affects all aspects of program delivery, including lactation and food supports. Second, accessible, tailored lactation support includes much more than education, and the CPNP is well-positioned to deliver this with adequate human and financial resourcing. Third, food supports are essential to the CPNP, contributing to both nutrition and social aspects of programming. Overall, lactation and food support delivery within the CPNP is responsive to client needs and the broader context of social determinants of health, but constrained by available resources. This study centres perspectives of community-based implementers of the CPNP, offering insights to inform planning, resourcing and programmatic guidance for community programs seeking to reduce health inequities during the critical perinatal period.